Study on the assesment of effective and safe protocols in ovulation induction by gonadotropin therapy

为了评估促性腺激素治疗促排卵的有效性和安全性，我们研究了3种方案，(1)常规FSH治疗（FSH治疗），(2)低剂量FSH治疗（LD-FSH治疗）和(3)顺序FSH和脉动GnRH治疗（FSH-GnRH治疗）2组下丘脑无排卵（HA）和多囊卵巢综合征（PCOS）患者。FSH- gnrh治疗组的平均治疗时间与FSH治疗组无明显变化，但LD-FSH治疗组的平均治疗时间较其他组长。卵泡的平均数量分别为FSH治疗组bbb、LD-FSH治疗组bbb、GSH-GnRH治疗组bb1。FSH-GnRH治疗每个治疗周期单个卵泡发生的发生率在HA患者中为70%，在PCOS患者中为50%。三组患者排卵、妊娠发生率比较，差异均无统计学意义。我们没有观察到多个怀孕LD-FSH治疗和FSH-GnRH治疗。卵巢刺激综合征（OHSS）发生率为FSH治疗组>LD-FSH治疗组>GSH-GnRH治疗组。特别是FSH-GnRH治疗组，明显低于其他组。这些数据表明，LD-FSH治疗是一种有效和安全的促性腺激素治疗方案，因为它减少了促性腺激素治疗、多胎妊娠和OHSS的副作用。然而,治疗时间长,副作用发生率的PCOS患者高于FSH-GnRH疗法。另一方面，FSH-GnRH治疗是减少副作用的促性腺激素治疗的最佳方案。综上所述，对于低风险无排卵患者，LD-FSH治疗是合适的促性腺激素治疗方案，而对于高风险患者，FSH-GnRH治疗是最佳方案。

To assess the effective and safe protocols in ovulation induction by gonadotropin therapy, we studied on 3 protocols, (1) conventional FSH therapy (FSH therapy), (2) low dose FSH therapy (LD-FSH therapy) and (3) sequential FSH and pulsatile GnRH treatment (FSH-GnRH treatment) for 2 patient group with hypothalamic anovulation (HA) and Polycystic ovary syndrome (PCOS).The mean treatment period in FSH-GnRH therapy is not changed with that of FSH therapy, but that of LD-FSH therapy is longer than other groups. The mean numbers of follicles are FSH therapy >LD-FSH thepy>GSH-GnRH therapy. The incidences of single folliculogenesis per treatment cycle by FSH-GnRH therapy were 70% in HA and 50% in PCOS.No significant differences were observed among 3 groups in the incidences of oulation and pregnency. We did not observe multiple pregnancy in LD-FSH therapy and FSH-GnRH therapy. The incidences of ovarian stimulation syndrome (OHSS) were FSH therapy>LD-FSH thepy>GSH-GnRH therapy. Especially, that in FSH-GnRH therapy was significantly lower than those in other groupsThese data suggested that LD-FSH therapy is a effective and safe protocol of gonadotropin therapy because it reduces the side effects of gonadotropin therapy, multiple pregnancy and OHSS.However, treatment periods is longer and the incidences of side effects in PCOS patients were higher than those in FSH-GnRH therapy. On the other hand, FSH-GnRH therapy is best protocol of gonadotropin treatment for reducing side effects.In conclusion of this study, LD-FSH therapy is a suitable protocol of gonadotropin treatment for low risk anovulation as HA, and FSH-GnRH therapy is best protocol for high risk patients.